RETROSPECTIVE STUDY OF PERITUMORAL CEREBRAL EDEMA CORRELATION WITH TUMOR SIZE, ITS LOCATION AND HISTOLOGICAL STRUCTURE OF SPHENOID WING MENINGIOMAS
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2021.3.12572Keywords:
перитуморальний набряк мозку, крило клиноподібної кістки, об’єм пухлини, ступінь злоякісностіAbstract
Summary. Meningiomas are one of the most common intracranial primary tumors. They are more common in women, their number increases with age. Sphenoid wing meningiomas make up 15–20 % of intracranial meningiomas.
The aim of the study – to evaluate the relationship between preoperative peritumoral cerebral edema (PTCE) and tumor size, histological structure and location.
Materials and Methods. Data from 67 patients with removed sphenoid wing meningioma in the period from January 2007 to January 2021 were retrospectively examined. One-factor and two-dimensional statistical analysis of factors that may affect PTCE was performed.
Results. The average age of the patients examined was 47 years (ranging from 20 to 74), men – 16 (23.9 %), women – 51 (76.1 %). The mean tumor volume was 32.8 cm3, ranging from 4.2 cm3 to 143.7 cm3. The edema index (EI) is 1 in 27 (40.3 %) was absent, EI > 1 in 40 (59.7 %) was present. Small tumor volume was in 21 cases, PTCE – 57.2 %, medium – 32 cases, PTCE – 59.2 %, large tumor volume was in 9 cases, PTCE – 66.7 % and giant – in 5 cases, PTCE – 60.0 %. According to the WHO classification, there were 54 cases of central nervous system malignant tumors grade I (80.6 %), which were classified into endothelial type – 37 (68.5 %), fibrous – 7 (12.9 %), transient – 5 (9.2 %), angiomatous – 6 (11.1 %) ) and psammomatous type, which was found in one patient. Tumors grade II – atypical type, found in 11 cases (16.4 %), and III – anaplastic type, were in 2 cases (3.0 %). In a one-way analysis, we found a significant relationship between PTCE and the degree of malignancy (χ2 = 8.59, p = 0.0034), while no relationship was found between PTCE and tumor volume (W = 627, p = 0.27). PTCE was more pronounced in the lateral, middle and medial variants of location and less pronounced in the case of spheno-orbital location of the tumor (p = 0.10) and the overall edema index (χ2 = 4.48, p = 0.034).
Conclusions. The relationship between PTCE and tumor volume is statistically insignificant. We found that high-grade (grade II and III) and low-grade subtypes (grade I, angiomatous type) are strongly associated with PTCE, although there is no relationship between the degree of malignancy and tumor location, χ2 = 0.37, p = 0.83. The results of a two-dimensional analysis of the simultaneous effect of tumor volume and PTCE on the pathological stage confirmed the higher risk of PTCE in tumors of grade II and III (p = 0.0027). There was also a small association between tumor volume and pathology (p = 0.74). A higher frequency of PTCE was found in the lateral variant in sphenoid wing meningioma, while a lower in spheno-orbital meningioma (p = 0.10), and a lower overall edema index (χ2 = 4.48, p = 0.034).
References
Bondy M, Ligon BL. Epidemiology and etiology of intracranial meningiomas: a review. J Neurooncol.1996;29: 197-205.
FrancoDeMonte, Michael W McDermott, OssamaAl-Mefty. Al –Mefty Meningiomas; second edition. New York; Thieme. 2011.
Al-Mefty O. Clinoidal meningiomas. J Neurosurg.1991;73: 840-9.
Schmidek HH, ed,; Meningiomas and Their Surgical Management. Philadelphia: W B Saunders Company.1991
Pierre-Olivier Champagne, Emile Lemoine, and Michel W. Bojanowski. Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries. Neurosurg Focus.2018;44(4): E12.
Raymond Y Huang, Wenya Linda Bi, Brent Griffith, Timothy J Kaufmann, Christian la Fougère, Nils Ole Schmidt, Jöerg C Tonn, Michael A Vogelbaum, et al,. The International Consortium on meningiomas.Imaging and diagnostic advances for intracranial meningiomas.Neuro-oncology. 2019;21(s1): 44-61.
Sekhar LN, Babii RP and Wright DC: Surgical resection of cranial base meningiomas. Neurosurgery Clinic of North America.1994;5(2): 258-313.
Bernstein M, Mitchel S Berger. Neuro-oncology. The Essentials; 3 ed. Thieme.2015.
Riemenschneider MJ, Perry A, Reifenberger G. Histological classification and molecular genetics of meningiomas. Lancet Neurol. 2006;5: 1045-54. Available from: https://doi.org/10.1016/S1474-4422 (06)70625-1
Claus EB, Bondy ML, Schildkraut JM, Wiemels JL, Wrensch M, Black PM. Epidemiology of intracranial meningioma. Neurosurgery.2005;57: 1088-95.
Bitzer M, Wöckel L, Morgalla M, Keller C, Friese S, Heiss E, Meyermann R, Grote E, Voigt K. Peritumoural brain oedema in intracranial meningiomas: influence of tumour size, location and histology. Acta Neurochir.1997;139: 1136-42.
Probst-Cousin S, Villagran-Lillo R, Lahl R, Bergmann M, Schmid KW, Gullotta F. Secretory meningioma: clinical, histologic, and immunohistochemical findings in 31 cases. Cancer.1997;79: 2003-15.
Gebel JM, Sila CA, Sloan MA, Granger CB, Weisenberger JP, Green CL, et al. Comparison of the ABC/2 estimation technique to computer-assisted volumetric analysis of intraparenchymal and subdural hematomas complicating the GUSTO-1 trial. Stroke. 1998;29(9): 1799-801. Available from: https://doi.org/10.1161/01.STR.29.9.1799
Zeidman LA, Ankenbrandt WJ, Du H, Paleologos N, Vick NA. Growth rate of non-operated meningiomas. J Neurol. 2008;255(6): 891-95. https://doi.org/10.1007/s00415-008-0801-2
Huttner HB, Steiner T, Hartmann M, Köhrmann M, Juettler E, Mueller S, et al. Comparison of ABC/2 estimation technique to computer-assisted planimetric analysis in warfarin-related intracerebral parenchymal hemorrhage. Stroke. 2006;37(2): 404-8. Available from: https://doi. org/10.1161/01.STR.0000198806. 67472.5c.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathologica. 2007;114(2): 97-109. Available from: https://doi.org/10.1007/s00401-007-0243-4
Perry A, Louis DN, Scheithauer BW, Budka H, Deimling Av. WHO grading of tumours of the central nervous system. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO classification of tumors of the central nervous system. Lyon: International Agency for Research on Cancer; 2007.
Violaris K, Katsarides V, Sakellariou P. The recurrence rate in meningiomas: analysis of tumor location, histological grading, and extent of resection. Open J Modern Neurosurg. 2012;2: 6-10. Available from: https://dx.doi.org/10.4236/ojmn.2012.21002
Stephen T. Magill, Jacob S. Young, Ricky Chae, Manish K. Aghi, Philip V. Theodosopoulos, and Michael W. McDermott. Relationship between tumour location, size, and WHO grade in meningioma. Neurosurg Focus. 2018;44(4): E4.
Bradac GB, Ferszt R, Bender A, Schorner W. Peritumoral edema in meningiomas: A radiological and histological study. Neuroradiology.1986;28: 304-12.
Kim IS, Kim HD, Kim KU, Shin HC, Choin HJ, Kim KH. Factors influencing the development of peritumoral brain edema in menigiomas. J Korean Neurosurg Soc.1997;26: 940-5.
Bitzer M, Opitz H, Popp J, Morgalla M, Gruber A, Heiss E, Voigt K. Angiogenesis and brain oedema in intracranial meningiomas: influence of vascular endothelial growth factor. Acta Neurochir (Wien). 1998;140: 333-40.
Park KJ, Kang SH, Chae YS, Yu MO, Cho TH, Suh JK, et al. Influence of interleukin-6 on the development of peritumoral brain edema in meningiomas. J Neurosurg. 2010;112: 73-80.
Benzel EC, Gelder FB. Correlation between sex hormone binding and peritumoral edema in intracranial meningiomas. Neurosurgy. 1988;23: 169-74.
Inamura T, Nishio S, Takeshita I, Fujiwara S, Fukui M. Peritumoral brain edema in meningiomas-influence of vascular supply on its development. Neurosurgery. 1992;31: 179-85.
Kalkanis SN, Carroll RS, Zhang J, Zamani AA, Black PM. Correlation of vascular endothelial growth factor messenger RNA expression with peritumoral vasogenic cerebral edema in meningiomas. J Neurosurg.1996;85: 1095-101.
Osawa T, Tosaka M, Nagaishi M, Yoshimoto Y. Factors affecting peritumoral brain edema in meningioma: special histological subtypes with prominently extensive edema. J Neuro-oncol. 2013;111(1): 49-57.
Lobato RD, Alday R, Gomez PA, Rivas JJ, Dominguez J, Cabrera A, et al. Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien).1996;138: 485-93.
Ildan Faruk, Erman Tahsin, kender Goc¸er A, Tuna Metin,Bagdatoglu Huseyin, Burgut Refik. Predicting the Probability of meningioma recurrence in the preoperative and early postoperative period: a multivariate analysis in the midterm follow-up. Skull Base 2007;17(3): 157-71.
Mantle RE, Lach B, Delgado MR, Baeesa S, Belanger G. Predicting the probability of meningioma recurrence based onthe quantity of peritumoral brain edema on computerized tomographyscanning. J Neurosurg.1999;91(3): 375-83.
Gurkanlar D, Er U, Sanli M, Ozkan M, Sekerci Z. Peritumoral brain edema in intracranial meningiomas. J Clin Neurosci. 2005;12: 750-3.
Lobato RD, Alday R, Gómez PA, Rivas JJ, Domínguez J, Cabrera A, et al. Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien). 1996;138: 485-93.
Vignes JR, Sesay M, Rezajooi K, Gimbert E, Liguoro D. Peritumoral edema and prognosis in intracranial meningioma surgery. J Clin Neurosci. 2008;15: 764-8.
Shristi Butta, Manoj Kumar Gupta, Sandeep B. V., Mallika Pal, Suniti Kumar Saha.The role of peritumoural brain edema in ascertaining the high risk meningiomas. Int J Res Med Sci. 2020;8(11): 3938-43.
Taohui Ouyang, Na Zhang, Long Wang, Zheng Li, Jian Chen, Sphenoid wing meningiomas: Surgical strategies and evaluation of prognostic factors influencing clinical outcomes Clinical Neurology and Neurosurgery.2015;134: 85-90.
Liang RF, Xiu YJ, Wang X, Li M, Yang Y, Mao Q, et al: The potential risk factors for atypical and anaplastic meningiomas: clinical series of 1,239 cases. Int J Clin Exp Med.2014;7: 5696-5700.
Bečulić H, Skomorac R, Jusić A, Alić F, Mašović A, Burazerović E, et al. Correlation of peritumoral brain edema with morphological characteristics and Ki67 proliferative index in resected intracranial meningiomas. Acta Clinica Croatica. 2019;58(1): 42.
Dolecek TA, Dressler EV, Thakkar JP, Liu M, Al-Qaisi A,Villano JL. Epidemiology of meningiomas post-Public Law107-206: The Benign Brain Tumor. Cancer Registries Amendment Act Cancer. 2015; 121:2400-10. DOI: 10.1002/cncr.29379
de Azambuja Pereira-Filho N, Pasqualotto Soares F, de Mello Chemale I, Barbosa Coutinho LM. Peritumoral brain edema in intracranial meningiomas. Arq Neuropsiquiatr. 2010;68: 346-9. Available from: http://dx.doi.org/10.1590/S0004-282X2010000300003
Kasuya H, Kubo O, Tanaka M, Amano K, Kato K, Hori T. Clinical and radiological features related to growth potential of meningioma. Neurosurg Rev.2006;29: 293-7. DOI: 10.1007/s10143-006-0039-3
Tamiya T, Ono Y, Matsumoto K, Ohmoto T. Peritumoral brain edema in intracranial meningiomas: effects of radiological and histological factors. Neurosurgery. 2001;49: 1046-52.
Shibuya M. Pathology and molecular genetics of meningioma: recent advances. Neurol Med Chir (Tokyo). 2015;55: 14. DOI: 10.2176/nmc.ra.2014-0233.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Bulletin of Medical and Biological Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
